Contact: Chris Black
202 333 3853
An ALFA initiative to eliminate the prescription drug expense paid by poor seniors who live in assisted living communities was filed today on Capitol Hill.
Reps. Lloyd Doggett (D-25th TX) and Lincoln Diaz-Balart (R-21st FL) and twelve other House members are sponsoring HR 5604, the Medicare Part D Home and Community Services Copayment Equity Act of 2008. This bipartisan measure corrects an apparent oversight in the Medicare Part D Prescription Drug Program by exempting drug co-payments for residents in assisted living and other home and community-based settings who qualify for both Medicare and Medicaid. The measure treats these so-called dual-eligible recipients the same as Medicaid recipients in nursing homes.
“Seniors should not be punished for living independently,’’ said Rep. Doggett. “The high cost of medicine should not force seniors into expensive institutional care. This bill treats all seniors equally, regardless of where they live.’’
“It is simply wrong that any Medicaid recipient pay a financial penalty for living in an assisted living community,’’ said Richard Grimes, ALFA’s president. “We are grateful Members of Congress from both political parties recognize this inequity and are taking steps to correct it.’’
The legislation will provide financial relief to one million seniors, including 125,000 residents of assisted living communities, and cost an estimated $171 million annually.
Prescription drug co-payments range from $1 to $5 for each prescription. The typical assisted living resident takes eight to 10 different prescription drugs per month, the same as residents of nursing homes. This legal oversight created hardship for Medicaid recipients whose personal needs allowance is limited to about $55 per month for items, such as clothing, shoes and personal hygiene items. Assisted living providers have been using their own funds to subsidize these affected residents for more than two years.
Assisted living services cost about one half the amount of nursing homes. Medicaid saves between 50 percent to 66 percent for each resident cared for in an assisted living community instead of a nursing home. More than 40 states have sought Medicaid waivers for assisted living for their residents who qualify and choose assisted living.
The Assisted Living Federation of America (ALFA, www.alfa.org represents professionally managed assisted living communities for seniors. ALFA advocates choice for seniors, quality of care, and accessibility and portability of long term care for all Americans.
